As we wrote last month, there are some things people can do to help reduce infectious diseases like flu, coronaviruses and other cooties in your home and work environments.

How infectious diseases spread…

Most infectious diseases are spread by close person-to-person contact primarily by touching people or things contaminated with bodily fluids (like pee, poop, sweat, droplets from sneezing, etc) — then touching your eyes, nose, or mouth.

Other diseases (like MRSA) can be spread by sharing personal items like towels or razors or by medical staff using contaminated items like stethoscopes, blood pressure cuffs, clipboards or charts, and pens. Keep in mind some bacteria or viruses can survive on objects for days, weeks or months.

Some things YOU can do to reduce the spread of germs

Since Bill is very immunocompromised, we are again sharing some things I / we do constantly to keep germs at bay with links to some of our blog posts.

Carry disinfecting wipes in your vehicles and backpacks, and put some in a baggie before you go out in public to wipe down surfaces of things you have to touch and/or to wipe your hands. (Keep in mind most wipes use ammonia, but there are some industrial wipes that use bleach instead. But never mix ammonia and bleach!)

Keep a box of cheap plastic disposable gloves in your vehicles so you can put on a pair when pumping gas or using ATMs or even shopping.

Wipe down everything that comes into your home with disinfecting wipes (or a rag dipped in water and bleach solution) including groceries or other items you buy at stores or something that is delivered to your door via ground or postal service.

Before you set your purse, backpack or briefcase on your kitchen table or countertop …think about all the places you put those things during the day! Either have a special place for these items in your home or office … or be meticulous about wiping them down before putting them on furniture, counters, carpet, desktops, etc. Also consider getting portable purse hooks to keep it off the floor of restaurants, public restrooms, etc.

Did you know cellphones carry 10 times more bacteria than most toilet seats..?! Think about all the places you use and place your phone every day. Then remember … germs thrive in warm environments and smartphones generate heat — plus your hands, face, mouth and body heat (if you carry your phone in a pocket) all add to the cootie cocktail so learn how to clean your phone.

Consider getting a UV disinfectant wand because its light rays kill up to 99.9% of germs and comes in handy for all types of handheld devices, ear buds, keyboards, remotes and many other gadgets and household items where cooties can thrive.

Fist bump rather than shaking hands — or just tell people you don’t shake hands. And if you do shake someone’s hand don’t touch your face (esp. eyes or mouth) before you are able to wash your hands.

Wash hands often with soap and water for at least 20 seconds. An easy way to mark the time is to hum the “Happy Birthday” song from beginning to end twice while scrubbing. If in a public bathroom, use paper towels to turn off water and to open the door when leaving.

When should you wash your hands?

Before, during, and after preparing food

Before eating food

Before and after caring for someone who is sick

Before and after treating a cut or wound

After using the toilet

After changing diapers or cleaning up a child who has used the toilet

After blowing your nose, coughing, or sneezing

After touching an animal or animal waste

After handling pet food or pet treats

After touching garbage

When you can’t wash hands while out in public, use a hand sanitizer (with at least 60% alcohol in it) or disinfectant wipes on hands (and keys, glasses, door handles, steering wheel, etc.) to reduce the spread of germs. But keep in mind sanitizers don’t work against some bugs so it’s best to wash up. Also people with celiac disease (like Bill) can’t do alcohol sanitizers so find other options like disinfecting wipes or gluten-free sanitizers.

Tell healthcare workers and visitors to wash their hands before they touch you or your stuff — don’t be timid!

If you have a fever, stay home! And wait at least 24 hours after fever breaks before you return to work or school.

Use antibiotics or antiviral meds only when absolutely necessary. Consider boosting your immune system to help fight infections.

Sick people should cover mouth and nose with tissue or sleeve when coughing or sneezing, wash hands often, and wear a face mask around others so you don’t spread your germs to others.

Disinfect things many people at work and school use like microwave buttons, spigots on water coolers, keyboards, calculators, phones, pens, staplers, etc. with a UV wand or bleach solution often or at least carry around some disinfecting wipes so you can clean items before use.

Medical Reserve Corps (MRC) is a national network of volunteers, organized locally to improve the health and safety of their communities.

The MRC network currently comprises over 180,000 volunteers in 830+ units located throughout the United States and its territories.

MRC units are community-based and function as a way to locally organize and utilize medical and non-medical volunteers who want to donate their time and expertise to prepare for and respond to emergencies and promote healthy living throughout the year. MRC volunteers supplement existing emergency and public health resources.

About the Medical Reserve Corps

After the September 11, 2001 terrorist attacks, many Americans asked, “What can I do to help?” Public health professionals were among those who wanted to volunteer their services, but many were not able to find a way to do so. While these professionals had applicable skills sets, they could not be deployed. This was because they were not identified, credentialed or trained in advance. So, the Medical Reserve Corps was created to build a group of people who can assist existing local public health in the event of a true public health emergency or disaster.

MRC was originally a partner program with Citizen Corps and resided under HHS’ Office of the Surgeon General. In 2015 the MRC was welcomed into HHS’ Office of the Assistant Secretary for Preparedness and Response (ASPR) Office of Emergency Management family. MRC also works closely with the National Association of County and City Health Officials (NACCHO) to enhance MRC units’ ability to meet local, state, and national needs through collaboration, coordination, and capacity-building activities.

MRC units engage volunteers to strengthen public health, improve emergency response capabilities, and build community resiliency. They prepare for and respond to natural disasters, such as wildfires, hurricanes, tornados, blizzards, and floods, as well as other emergencies affecting public health, such as disease outbreaks. They frequently contribute to community health activities that promote healthy habits.

Volunteers include medical and public health professionals such as physicians, nurses, pharmacists, dentists, veterinarians, and epidemiologists. Many community members with non-medical backgrounds—interpreters, chaplains, office workers, legal advisors, and others—can fill other key support positions.

Some examples of activities that MRC volunteers participate in and support include:

Emergency Preparedness and Response Trainings

Mass Dispensing Efforts

Emergency Sheltering

Vaccination Clinics

Responder Rehab

Health Education and Promotion

Disaster Medical Support

Outreach to Underserved Community Members

Medical Facility Surge Capacity

First Aid During Large Public Gatherings

Engaging Youth in Public Health Activities

Planning, Logistical & Administrative Support

Health Screenings

Veterinary Support and Pet Preparedness

and more!

To volunteer or partner with your local Medical Reserve Corps, visit their Find MRC Units page to locate the unit nearest you and reach out to the unit coordinator and visit https://mrc.hhs.gov to learn more about this great organization.

MRC Network Well Check Webinars

MRC Network Well Check interactive webinars provide MRC unit leaders and State Coordinators with information on a wide variety of topics, largely determined by members’ interests and needs. Through these ongoing wellness check-ups of the MRC network, members will be provided a platform to connect, share, and learn with your peers and leadership, plus some members will also be asked to serve as presenters.

Webinars are typically held on the first Tuesday of each month at 2p ET and run about 60 minutes long primarily focusing on a specified topic. Many include a Q & A period and highlights from the field, as well. Visit https://mrc.hhs.gov/pageviewfldr/WellCheckCalls to find upcoming and archived webinars.

Many MRC units use customized It’s A Disaster books

Since Medical Reserve Corps’ creation in 2002 many Health Departments and MRCs (+ EMs, CERTs, etc.) have purchased our 266-page preparedness and first aid manuals customized both in the print process and using standard red books with stickers for volunteers, events and local communities.

Our IT’S A DISASTER! bulk price is only $4.50 U.S. each delivered (70% off list on 10 or more copies) … and we can customize them for free to include data about your MRC unit, how to become a volunteer, public health information and more. And our book qualifies as community education on most grants providing about a $4-to-$1 return that can be used on matching grant programs.

Obviously there is angst and concern about the new coronavirus (COVID-19) spreading across the globe, but realize there are many infectious disease outbreaks that impact us each and every year that don’t get much coverage.

For example, here are some infectious disease numbers…

Tuberculosis caused over 500 deaths out of the 9,025 TB cases in the U.S. in 2018 per CDC … and globally there were 1.2 million TB deaths out of the 10 million new cases worldwide in 2018 per WHO.

COVID-19 has caused 33,106 deaths globally out of 693,282 cases per WHO as of 30-Mar-2020. (Out of the global stats, the U.S. reports 2,112 fatalities and 122,652 confirmed cases as of 30-Mar-2020.)

Staph caused an estimated 20,000 deaths in the U.S. out of 119,000 cases in 2017 per CDC with less than half the deaths linked to drug-resistant MRSA.

Clostridium difficile or C. diff sickens almost half a million Americans a year killing over 29,000 of them within 30 days of diagnosis per InfectionControlToday.com.

Seasonal flu killed between 12,000 and 61,000 Americans annually over the past decade according to CDC … and WHO estimates there are between 290,000 to 650,000 flu deaths worldwide annually.

Bottom line, these are just some examples of infectious diseases that can affect people year-round, and other diseases are being introduced (and re-introduced) into countries through air travel, border crossers, contaminated surfaces and more.

How infectious diseases spread…

Most infectious diseases are spread by close person-to-person contact primarily by touching people or things contaminated with bodily fluids (like pee, poop, sweat, droplets from sneezing, etc) — then touching your eyes, nose, or mouth. Other diseases (like MRSA) can be spread by sharing personal items like towels or razors or by medical staff using contaminated items like stethoscopes, blood pressure cuffs, clipboards or charts, and pens. Keep in mind some bacteria or viruses can survive on objects for days, weeks or months.

Immunocompromised = germaphobe

Many of you may remember Bill has been battling major health issues for well over a decade (including leukemia, T-cell disease, etc.) and, whenever a family member is immunocompromised, you become a major germaphobe.

Before we list the typical things people can do to reduce infectious diseases, we wanted to mention some things I / we do constantly to keep germs at bay with links to some of our blog posts.

Carry disinfecting wipes in your vehicles and backpacks, and put some in a baggie before you go out in public to wipe down surfaces of things you have to touch and/or to wipe your hands. (Keep in mind most wipes use ammonia, but there are some industrial wipes that use bleach instead. But never, ever mix ammonia and bleach!)

Wipe down everything that comes into your home with disinfecting wipes (or a rag dipped in water and bleach solution) including groceries or items you bought at the store or something that is delivered to your door via ground or postal service. And if you are concerned about household chemicals, we’ve posted some safety tips and links on making non-toxic cleaners on our blog.

Before you set your purse, backpack or briefcase on your kitchen table or countertop …think about all the places you put those things during the day! Either have a special place for these items or be meticulous about wiping them down before putting them on furniture, counters, carpet, etc.

Did you know cellphones carry 10 times more bacteria than most toilet seats..?! Think about all the places you use and place your phone every day. Then remember … germs thrive in warm environments and smartphones generate heat — plus your hands, face, mouth and body heat (if you carry your phone in a pocket) all add to the cootie cocktail so learn how to clean your phone.

Consider getting a UV disinfectant wand because its light rays kill up to 99.9% of germs and comes in handy for all types of handheld devices, ear buds, keyboards, remotes and many other gadgets and household items where cooties can thrive.

Keep a box of cheap plastic disposable gloves in your vehicles so you can put on a pair when pumping gas.

Fist bump rather than shaking hands — or just tell people you don’t shake hands. And if you do shake someone’s hand don’t touch your face (esp. eyes or mouth) before you are able to wash your hands.

What to do to reduce the spread of infectious diseases…

Wash hands often using soap and water or use hand sanitizer (with at least 60% alcohol in it) to reduce the spread of germs. But keep in mind sanitizers don’t work against some bugs so it’s best to wash up. Also people with celiac disease (like Bill) can’t do alcohol sanitizers so find other options like disinfecting wipes or gluten-free sanitizers.

The following hand washing chart and tips appeared in a custom book we printed for LaSalle County Emergency Management Agency’s Medical Reserve Corps and, although most of this is common sense, we wanted to share their tips and remind people to hum “Happy Birthday” in your head twice while scrubbing. Another tip when using a public washroom is… use the paper towels you dried your hands with to turn off water and to open the door when leaving.

When should you wash your hands?

Before, during, and after preparing food

Before eating food

Before and after caring for someone who is sick

Before and after treating a cut or wound

After using the toilet

After changing diapers or cleaning up a child who has used the toilet

After blowing your nose, coughing, or sneezing

After touching an animal or animal waste

After handling pet food or pet treats

After touching garbage

Tell healthcare workers and visitors to wash their hands before they touch you or your stuff — don’t be timid!

If you have a fever, stay home! And wait 24 hours after fever breaks before you return to work or school.

Use antibiotics only when absolutely necessary. Consider boosting your immune system to help fight infections.

Sick people should cover mouth and nose with tissue or sleeve when coughing or sneezing, wash hands often, and wear a face mask around others (if very ill).

Disinfect things many people at work and school use like microwave buttons, spigots on water coolers, keyboards, calculators, phones, pens, staplers, etc. with a UV wand or bleach solution often or at least carry around some disinfecting wipes so you can clean items before use.

Coronaviruses are a large family of viruses that can infect birds and mammals, including humans, and is traditionally associated with the common mild cold in people.

Sometimes coronaviruses that infect animals, including camels, bats, cattle, cats and snakes, can evolve and make people sick then become a new human coronavirus.

Some examples of animal coronaviruses that crossed over and spread person-to-person are the severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and now the new 2019-nCoV (a.k.a. COVID-19.)

As of 17-Feb-2020, authorities in China say the death toll from COVID-19 is over 1,700 (well surpassing the deadly 2003 SARS outbreak), with most deaths occurring in the Chinese province of Hubei (esp. Wuhan city) where the coronavirus was first discovered.

Globally there are (now) about 693,282 confirmed cases of the virus so COVID-19 (formerly 2019-nCoV) has over a 4% mortality rate as of 30-Mar-2020 globally (and about 2% in the U.S. as of 30-Mar). And this outbreak is far from over as millions of Chinese returned to work after the extended Lunar New Year break ended. But realize the Spanish flu of 1918, which was the last true global pandemic, had a “case fatality rate” or CFR of 2.5%, and it killed an estimated 50 – 60 million people.

The fatality rates for MERS was about 35% and SARS was around 14-15% which is why those coronaviruses were very concerning, but countries were able to contain things in both cases so thankfully neither became a pandemic.

Interestingly Live Science says one group has escaped with minimal damage so far: children. Other coronaviruses, including SARS and MERS, also showed this pattern. Currently the median age of 2019-nCoV patients is between 49 and 56 years old, according to a recent JAMA article.

Symptoms and Complications

COVID-19 infection can range from mild, with no symptoms or minor symptoms, to severe or even deadly. The symptoms usually start between 2 to 14+ days after you get infected and can include:

Fever

Cough

Sore throat

Runny nose

Shortness of breath or breathing difficulties

It can also cause pneumonia and progress to multiple organ failure or death in some severe cases.

There is a test for 2019-nCoV [COVID-19], but there’s no vaccine or specific treatment yet other than medical care to help relieve symptoms, although Gilead’s experimental drug called remdesivir is being trialed in some cases.

As Dr. Sircus reports, some patients who at first appeared mildly or moderately ill then took a turn for the worse several days or even a week into their illness. The median time from their first symptoms to when they became short of breath was 5 days; to hospitalization, 7 days; and to severe breathing trouble, 8 days. Experts say that pattern means patients must be carefully monitored, and it is not safe to assume that someone who seems to be doing well early on is out of the woods. But, as Dr. Sircus says, “remember at least 95 percent of people survive it! Cancer patients should be so lucky.”

At a time when many are rightly concerned about coronavirus — of which there are just a handful of cases in the U.S. so far — the CDC is also warning Americans not to drop their guard about influenza, which has caused at least 19 million illnesses, 180,000 hospitalizations, and 10,000 deaths so far this season.

The immediate risk to the U.S. is currently low, and a presidential proclamation in place suspends entry of foreign nationals who have visited China within the past 14 days into America. The CDC has also put into place measures to detect this virus among those who are allowed entry into the U.S. who are entering the country within 14 days of having been in Hubei province or mainland China.

All of these passengers are being directed to 1 of 11 U.S. airports where American citizens and exempted persons who have been in Hubei province will have an additional health assessment. They will be screened for fever, cough, difficulty breathing.

If symptomatic, American citizens and those who are exempt will be transferred for further medical evaluation. They will not be able to complete their itinerary and will be isolated for 14 days.

If asymptomatic, American citizens and those who are exempt will be subject to a mandatory 14-day quarantine at or near that location.

The list of 11 airports are…

San Francisco International Airport, California;

Los Angeles International Airport, California;

Hartsfield-Jackson Atlanta International Airport, Georgia;

Daniel K. Inouye International Airport, Hawaii;

O’Hare airport, Illinois;

Detroit Metropolitan Airport, Michigan;

Newark Liberty International Airport, New Jersey;

JFK, New York;

Dallas/Fort Worth International Airport, Texas;

Washington Dulles International Airport, Virginia;

and Seattle-Tacoma International Airport, Washington.

The Department of Defense has identified housing support at 4 bases for up to 1,000 people who may need to be quarantined upon arrival from overseas travel. Currently DOD is housing 198 people at March Air Reserve Base, California, but DOD is not involved with treatment or observation of those at the facility; Health and Human Services is doing that.

The 4 bases are…

Marine Corps Air Station Miramar, California;

Travis Air Force Base, California;

168th Regiment, Regional Training Institute in Fort Carson, Colorado;

and Lackland Air Force Base, Texas.

So what can people do?

First – don’t panic since Americans are still currently low risk and the focus right now is on travelers returning from places where this disease rate is growing.

And as mentioned above, it is still active flu season here in the U.S. which has sickened millions and killed 10,000 people so far. Use the below common sense tips from both CDC and our preparedness and first aid manual to help reduce the spread of germs and infectious diseases.

CDC guidance

If you haven’t already, consider getting a flu shot and take flu antivirals if prescribed.

CDC does not recommend that people who are well wear facemask to protect themselves from respiratory viruses, including COVID-19.

Wash your hands often with soap and water for at least 20 seconds – especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. An easy way to mark the time is to hum the “Happy Birthday” song from beginning to end twice while scrubbing.

Use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Avoid touching your eyes, nose and mouth with unwashed hands.

Avoid close contact with people who are sick.

Stay home when you are sick or becoming sick.

Cover your cough or sneeze with a tissue (not your hands) and throw the tissue in the trash.

Clean and disinfect frequently touched objects and surfaces.

Practical precautions

Do not travel while sick.

Seek medical care right away if you have both symptoms of fever, cough and shortness of breath and have either recently returned from China or have direct exposure to others diagnosed with a coronavirus.

Before going to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.

Cover mouth and nose with tissue or sleeve (not your hands) when coughing or sneezing.